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Biomedical subjects

M Mani

Publications and source records attributed to M Mani.

At least 19 recordsLinked to original sources

Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: a multicentre study.

PURPOSE: Methicillin resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. We report the prevalence and antibiotic susceptibility pattern of MRSA in major southern districts of Tamilnadu. METHODS: A total of 7172 clinical specimens and 1725 carrier screening samples were collected from different centers and subjected to MRSA screening using conventional microbiological methods. Subsequently the antibiotic sensitivity test was performed for the confirmed MRSA isolates. RESULTS: Out of 906 strains of S. aureus isolated from clinical and carrier samples, 250 (31.1%) and 39 (37.9%) were found to be methicillin resistant respectively. Almost all clinical MRSA strains (99.6%) were resistant to penicillin, 93.6% to ampicillin, and 63.2% towards gentamicin, co-trimoxazole, cephalexin, erythromycin, and cephotaxime. All MRSA strains (100%) of carrier screening samples had resistance to penicillin and about 71.8% and 35.9% were resistant to ampicillin and co-trimoxazole respectively. Multidrug resistance was observed among 63.6% of clinical and 23% of carrier MRSA isolates. However, all strains of clinical and carrier subjects were sensitive to vancomycin. CONCLUSION: The determination of prevalence and antibiotic sensitivity pattern of MRSA will help the treating clinicians for first line treatment in referral hospitals.

Anti-Bacterial Agents↗

1,3,5-Triiodo-2,4,6-trimethylbenzene at 293 K.

In the structure of triiodomesitylene (1,3,5-triiodo-2,4,6-trimethylbenzene), C(9)H(9)I(3), at 293 K, the benzene ring is found to be significantly distorted from ideal D(6h) symmetry; the average endocyclic angles facing the I atoms and the methyl groups are 123.8 (3) and 116.2 (3) degrees, respectively. The angle between the normal to the molecular plane and the normal to the (100) plane is 5.1 degrees. No disorder was detected at 293 K. The thermal motion was investigated by a rigid-body motion tensor analysis. Intra- and intermolecular contacts are described and topological differences compared with the isomorphous compounds trichloromesitylene and tribromomesitylene are discussed.

Journal Article↗

Merits of performing coronary artery by-pass grafts on the beating heart.

A retrospective study of 1006 patients was undertaken to evaluate the benefit of a change of strategy in performing coronary artery by-pass grafting surgery. Group A consisted of 500 patients who were consecutively operated on cardiopulmonary by-pass and group B consisted of 506 patients who were consecutively operated on using "off pump" techniques. Pre-operative risk profile in both groups were similar as was as in the operating time. There was distinct benefit in amount of homologous transfusion, period of ICU stay, increased usage of radial artery conduit and improvement in transoesophageal echocardiography assessment of ischaemic mitral incompetence immediately after revascularisation in off pump (group B). Though there was a lower mortality in group B ie, 3/506 vis-a-vis 10/500 in group A this is not of statistical significance. Improvement in left ventricular ejection fraction >5.0% occurred more frequently in one month follow-up visits of group B patients. Period of return to active life was also shorter (28 versus 56 days). Based on observations, we conclude that there is a distinct benefit in avoiding cardiopulmonary by-pass while performing coronary artery by-pass grafting.

Coronary Artery Bypass↗

Chemosensitivity of lymphocytes from patients with B-cell chronic lymphocytic leukemia to chlorambucil, fludarabine, and camptothecin analogs.

Chemosensitivity of B lymphocytes, obtained from 65 patients with B-cell chronic lymphocytic leukemia (B-CLL), Rai stages 0 through IV, was determined using the MTT assay. The results were expressed by the drug concentration required for 50% inhibition of cell viability (IC50). The cytotoxicity of chlorambucil (CLB) was compared with that of fludarabine and the DNA topoisomerase I inhibitors, camptothecin, 9-aminocamptothecin, 10,11-methylenedioxy-20(S)-camptothecin (10,11-MDC) and 9-amino-10,11-methylenedioxy-20(S)-campthothecin (9-A-10,11-MDC), and topotecan. Considerable heterogeneity in sensitivity to CLB was observed, with a median IC50 of 40.5 mumol/L in untreated patients. B-CLL cells from patients treated with CLB had a significantly higher median IC50 of 86.0 mumol/L (P < .01). Untreated as well as CLB-treated patients were divided into two subsets. For the purpose of this study, B-CLL lymphocytes with an IC50 CLB of less than 61.0 mumol/L were designated as "sensitive" and those with an IC50 CLB of > or = 61.0 mumol/L were designated as "resistant." After baseline assays, 15 untreated patients received CLB; after treatment, the IC50 increased in B-CLL lymphocytes from 13 of 15 patients. The response to CLB treatment, determined by its effect on the absolute lymphocyte count and by the Eastern Cooperative Oncology Group clinical criteria, was significantly better in patients whose lymphocytes had an IC50 CLB of less than 61.0 mumol/L before therapy (P < .01). B-CLL lymphocytes also had a variable degree of sensitivity in vitro to each of the other drugs. There was significant cross-resistance between CLB and fludarabine (P < 0.01). Whereas only 29% of CLB-resistant B-lymphocyte specimens obtained from individual patients were sensitive to fludarabine in vitro, 52% and 67% of CLB-resistant lymphocyte samples were sensitive to 10,11-MDC and 9-A-10,11-MDC, respectively. We have previously reported that p53 gene mutations were associated with aggressive B-CLL and a poor prognosis. B lymphocytes from seven patients with these mutations were resistant to CLB, and five of six were resistant to fludarabine. Lymphocytes from four of seven were resistant to 10,11-MDC, and three of four were resistant to 9-A-10,11-MDC. This study implies that the MTT assay may be useful in identifying subsets of CLL patients resistant to conventional chemotherapy. However, definitive conclusions can not be drawn in view of the small number of patients studied prospectively. In addition, these results suggest the potential of camptothecin-based therapy for patients unresponsive to standard treatment.

Antineoplastic Agents↗

Decreased L system amino acid transport and decreased gamma-glutamyl transpeptidase are independent processes in human chronic lymphocytic leukemia B-lymphocytes.

The L system of amino acid transport is markedly diminished in chronic lymphocytic leukemia (CLL) B-lymphocytes, with a maximal velocity less than 15% that of normal B-lymphocytes. Another membrane-associated function, the activity of the ectoenzyme, gamma-glutamyl transpeptidase (GGT), is diminished in CLL B-cells to 30% that of normal B-cells. In addition to its transpeptidase activity, a role for GGT has been postulated in the transport of amino acids. In the present report, the possible relationship of these two physiologic functions CLL B-cells was studied. The L system transport defect in CLL is restored by phorbol ester-induced cell maturation; following incubation with 0.15 microM tetradecanoyl phorbol acetate (TPA) for 17 hours, the L system initial velocity showed a 20-fold increase. In contrast, there was no significant effect on GGT activity with cell maturation. Furthermore, an antibody which diminished GGT activity by 50% in lymphoid cells did not inhibit L system transport. Thus, the impaired L system amino acid transport and GGT activity appear to be independent processes in CLL B-cells.

Amino Acids↗

Urethral strictures in boys.

While common in adult males, urethral strictures are comparatively rare in boys. We report our experience with this condition in 19 boys. Ten of the strictures were iatrogenic, seven traumatic, and three inflammatory in origin. Dilation is reportedly unsatisfactory for the management of most urethral strictures in children. In our series, however, 9 patients (47.3%) underwent urethral dilation as the only definitive form of treatment, while urethroplasty was successfully performed in the other 10 cases.

Child↗

[Carcinoma in mature cystic teratoma of the ovary: pathology, therapeutic and prognostic problems].

Carcinoma develops in about 1-2% of ovarian mature cystic teratomas, usually in postmenopausal women, squamous cell carcinoma being the most common tumor type. This study is based on a review of 300 published and 5 new cases. The carcinomatous tissue tends to invade adjacent organs, whereas lymph node metastasis has rarely been diagnosed. A five-year survival rate of about 15% testifies to the poor prognosis. The treatment of tumors confined to the ovary (stage Ia, Ib; FIGO) usually consists of bilateral oophorectomy and total hysterectomy. Exceptionally, in young women of childbearing age, treatment may be limited to unilateral oophorectomy. A thorough surgical, cytologic and bioptic examination of the abdominal cavity should be done to confirm an early tumor stage. In more advanced stages (FIGO Ic to IV), complete eradication of the malignant tissue offers the only chance of cure. The efficacy of chemo- and radiotherapy has not been studied systematically. We suggest that carcinoma in mature cystic teratoma be staged and treated according to the guidelines established for common epithelial neoplasms of the ovary.

Adenocarcinoma↗

Extradural analgesia revisited. A statistical study.

The results of 334 lumbar extradural analgesics, administered in a standard manner, allowed reassessment of some factors influencing the spread of local anaesthetic solution in the extradural space. There was no evidence of increased spread in patients with degenerative vascular disease when compared with a control group free from such disease. The patient's height and age had a small effect on spread. The results contradict the earlier assumption of a direct relationship between the volume of anaesthetic solution injected and the number of segments blocked.

Adult↗

Premedicant drugs and gastric juice pH and volume in pediatric patients.

The effects of premedication on gastric juice volume and pH were evaluated in five groups of 206 pediatric patients undergoing elective surgical procedures: Group 1 (Control) received no premedication; Group 2 was given morphine sulfate and pentobarbital as premedicants. The other groups received, in addition to morphine and pentobarbital, atropine (Group 3), scopolamine (Group 4), or glycopyrrolate (Group 5). After endotracheal intubation, gastric aspirates were examined for volume, pH and color. Neither premedication with morphine and pentobarbital nor addition of atropine or scopolamine to the premedication significantly altered volume. In patients treated with glycopyrrolate, volume was reduced to less than a third of that of patients in Group 1 (P less than 0.001), and the percentage of pH's higher than 2.5 was significantly greater than in other groups. The incidences of unobtainable samples and samples with pH's higher than 2.5 were greatest with atropine (32.0 per cent, P less than 0.05) and glycopyrrolate (58.1 per cent, P less than 0.01). In 60 per cent of the bile-stained specimens, pH's were below 2.5. It is concluded that because of its selective inhibitory effect on gastric acid secretions, glycopyrrolate appears superior to other anticholinergic drugs. The reduction of gastric juice volume and acidity produced by glycopyrrolate would have important clinical implications in case of accidental aspiration. It is also concluded that bile staining of gastric contents is not a reliable indicator of gastric juice pH.

Atropine↗